Donna Chapla doesn't remember the day last November when her life was saved by three telephone buttons.
But her husband Steve does.
"Donna was preparing a meal when she sat down next to the dining room table and suddenly I heard her fall to the floor," Steve said. "I was pretty alarmed. I tried to lift her, but I couldn't, because she had fallen between two pieces of furniture. So I called 911.
"They were here in less than three minutes," Steve said, still astounded."Donna wouldn't have made it if she hadn't received help right away."
The Chapla's daughter, Loretta Shiya, agreed.
"That call to 911 absolutely saved my mother's life," Shiya said. "When we were contacted (while vacationing) in California, they didn't expect her to live, so we had a horrible drive coming home. But by the time we got to her, she was conscious. The doctor said it was a miracle."
Although the events of that day are lost in a fog for Donna, who has bounced back nicely from the massive heart attack she suffered, she does remember that last detail.
"When your doctor calls you his miracle," the octogenarian said, "you can't help but feel pretty lucky."
Of course, Donna had more than just luck on her side.
Each year, 1.1 million Americans experience a heart attack, and 460,000 of them almost half are fatal. Of those who die, almost half do so before they can get to a hospital.
Those numbers would be frightening on any day, but they take on special significance every Sept. 11 or 9/11 when the nation's public safety communications centers celebrate National 911 Day.
Initiated by the National Emergency Number Association to emphasize the importance of calling for emergency medical help, this year's day of 911 recognition is being joined by the National Heart, Lung, and Blood Institute (NHLBI) and the American Heart Association (AHA) to underscore the urgent need for speedy responses in cardiac situations.
"Minutes can mean life, death, or disablement yet, too many people don't call 911, and very few know the warning signs of heart attack or stroke," Richard Gray, AHA's communications director in Phoenix, said.
"Only one of five heart attack victims is treated in time and often, that's their own choice," he said. "There are people who drive themselves to hospitals, risking their own life and the lives of others on the road, only to sit in waiting rooms instead of getting right in for treatment; who don't call because they don't want to be a bother; who are too embarrassed to call; or who just want to save an ambulance bill."
The result, Gray said, is that such folks are "putting a small price on their own life."
Acting in time
The NHLBI and the AHA hope to turn the delayed-treatment trend around with a major new heart attack education campaign called "Act in Time to Heart Attack Signs" which targets patients and the general public as well as physicians and seeks to raise awareness about the need for a fast response.
The key campaign messages encourage recognition of heart attack symptoms; working with a physician to create a heart attack survival plan; and calling 911 as soon as symptoms begin.
"Our goal is to save lives by increasing the woefully low number of heart attack patients who are treated within the first hour of experiencing symptoms," said NHLBI Director Claude Lenfant. "It is during that crucial 60-minute window that clot-busting medication and other treatments are most effective. Alarmingly, only 1 in 5 patients gets to the hospital emergency department soon enough to benefit from these treatments.
"Most potential heart attack victims wait at least two and possibly four hours before seeking medical help and some wait a day or more," Lenfant adds.
One reason people wait before getting help is that they do not realize they are having a heart attack because their symptoms do not match the sudden crushing chest pain depicted in the movies the so-called "Hollywood heart attack."
"The reality," AHA President David Faxon said, "is that many heart attacks are much quieter, causing only mild pain or discomfort.
In addition to uncertainty about symptoms, many patients fear they will be embarrassed if their symptoms turn out to be a false alarm. And the majority of women still view heart attacks as a "male" problem even though cardiovascular disease is the leading killer of both men and women."
Campaign materials point out that calling 911 can increase survival not only by helping patients get to the hospital fast but also because emergency medical personnel can give a variety of medications and treatments even before arrival at the hospital.
Act in Time provides various educational materials for health care providers, heart attack patients and the public. These include a booklet, an educational video, and new Web pages, which can be reached through the NHLBI website at www. nhlbi.nih.gov.
Matters beyond the heart
Arizona and Kansas, incredibly, are the only two states in the country in which official National 911 Day activities are held annually.
In Phoenix last year, dispatchers attended a Diamondbacks baseball game and awards presentation at the Arizona State Capitol, while Diamondbacks third baseman Matt Williams and manager Buck Showalter appeared in public service announcements asking accidental wireless 911 callers to stay on the line until the dispatcher answers and not to hang up immediately. (Officials estimate that Phoenix-area dispatchers field 500 calls a day where a person accidentally dials with his/her cellular phone, then hangs up.)
But there are celebrations of other, quieter kinds that 911 dispatchers experience regularly and that also have to do with the human heart.
"One morning after Halloween, I received calls from three mothers whose children were choking on a hard candy," Jill Van Kamp, a Payson 911 dispatcher for 7 years, said.
"One was a young mother who was, naturally, very distraught. I didn't do anything spectacular. I didn't even tell her what to do. I just asked if she knew the Heimlich maneuver and how to flip her baby over. Well, she did and she did it right there. The candy popped out while I was on the phone with her."
And the celebration?
"I was fine until I hung up," Van Kamp said, "and then I just sat in my chair and bawled."
Dial 911 Fast
Heart attack and stroke are life-and-death emergencies every second counts. If you see or have any of the listed symptoms, immediately call 911. Not all these signs occur in every heart attack or stroke. Sometimes they go away and return. If some occur, get help fast.
Some heart attacks are sudden and intense but most heart attacks start slowly, with mild pain or discomfort. Often the people affected aren't sure what's wrong and wait too long before getting help. Here are some of the signs that can mean a heart attack is happening.
Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath. This feeling often comes along with chest discomfort. But it can occur before the chest discomfort.
Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness.
If you or someone you're with has chest discomfort, especially with one or more of the other signs, don't wait longer than a few minutes (no more than 5) before calling for help.
Calling 911 is almost always the fastest way to get lifesaving treatment. Emergency medical services staff can begin treatment when they arrive - up to an hour sooner than if someone gets to the hospital by car. The staff are also trained to revive someone whose heart has stopped. You'll also get treated faster in the hospital if you come by ambulance.
Source: The American Heart Association